17C-245 (6) CDC' Construction
15 8 North Maple Street
Florence, MA 01062
(413)585-8677
February 28, 2006
Louise Jeffway
225 Elm Street
Northampton, MA 01060
584-5436
Re; Roofing services (driveway side only) at North Main Street, Florence.
Propose to remove all existing layers of roofmg and dispose of properly. Then
to cover entire area with plywood. Weather shield will be installed at all eaves
and valleys, new drip edge throughout, 15 lb felt paper over entire area and
finally to cover with 30 year Architectural asphalt shingles (Harvard Slate).
Price includes all necessary flashings.
The sum of this proposal is Five Thousand Eight Hundred Sixty dollars
($5,860.00). $3,000.00 to start balance upon completion.
Thank you very much,
CDT Construction CJ
022820061930eat
Acceptance Date 23 / D
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�'CtiAAfPl.
� � �lassa�ltusetts � ��
DEPARTMENT OF BUILDWIG INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building '
Nordiampton, MA 01060
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HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as lids/her construction sup(:zisor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be, a one or two amp _
dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a
home owner."
The building department for the City of Northampton wants any person(s)-who seek-to
use the,home owner exemption, to act as their own construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and r',egulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation/footings (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection.:The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work(electrical, plumbing& gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
L understand the above.
(Home owner/resident's signature requesting exemption)
i will call to schedule all required buiiding inspections necessary iur the uuiiuiiig PUI 11iit
issued-to me
Date
Address of work
location
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O¢Y1Wdp�O J,.
R E UZ��7 II{ �\Tc ril}U1117Jtoil
W DEPARTMENT OP DUILt)r)\,G INSPPCTlOt'S
212 Alain Street t��unici al Duildin
I P G
Northampton, Mass. 010GO
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NNY01UUIt'S CONIPEI SA'1ZO.N MSURANCE 1:FFM V-1-1-
(li can permi ttm)
" itb a pM-Icipa! place of businessfresidence at: -
i
i
�- �- - (phone')
(s x/ci rr/statrlb p)
jdo hereby certify, under the puns and penalties of perjury:, `.hai
I ( ) I am an employer providing die following I%vorkcr's coinocnsa:Jon cove-lgc for im
etuployces working on tills job:
(In nl r� Corr�) (Polic aixr) — (r:pirrior.Dzr�}
I a s - fir, genera] conrraezor or homeov��er (c c:e one) arc have hired
the conSaCOrs listed below wbo have the followinp, worker's compen_s2non policies:
i
1 (-1-";Z! ,- Of CO:'.MCiOr) (IRn ranc:. Cornpart)-/PoU(.7, }\turnr{;) (ExpinjucCn D'Itc)
1
(Name.of C000-2clor) (IJ17arancc C0IDDan1'/PO'jM, `unc_r) (Li-piriion Dale)
(Name of Con.iraelor) Rnsurancz- CompanyfPoucy Nuurb-.r) (E-Cpiraoo Dalc)
1 -
(Name of Contractor) (Iosuran Compacry/Policy Numb`r) t�xpiruon Daly).
-
(nax'a `OQI t,cG.ilnctz�ti-to ircuc�iar«miioa pcuaisia6 w.11 ooa�-to s)
(y�I am a sole-proprietor and baye no one wcrldDg for me-
( ) I aQ1,2 home owner performing zll the work myself.
NOTE:pl=-c be zMrc o—v�}c hem o.�vcra who cr_ploy pcwca co do -• - • c=--,=joc cr rq>r--ork an or
oat more i�a Ll---- rich the bomoawvc rtada or co the gvvm6 zpputen-*•+tb�--,�-r ox C=�=Ily ccsd.--cd to be
employes unZ=the--ai-�c-Y--.L=Au(GUl1 Z=1(5)):ppti--L.ioa by a bomraova rc c or pa-mil r=y evid_^ooc the
IcSA ct=u or ea c=:Ploy, under drn Wo k.oe,Coofi om,aSioa Act
I
l I undcss�.na tha>ooyy of thi.mss may bo for�na,ded w rbo Dcpumcoi orintl�c:sicl/ucdmt�'Offioo orlrs�•aoo ror th.
oo°ex;�c reiGetioa aad th-t f_iltae to isz+rt IcovertZe u13e lc z on 25 A of 1.141-152 c=lctd to the impcai6ca or eiMi=l pea*LW=
¢om-i:.sxg of.five or up to S S00-00 Iwor or up to ooe y-.=-ea3 ctiil pm.lie io'ue roan or.Stop Wort;Orcte a"ad
fie oC 5100.00 s d:.y ePI=me
t For 6cp.na.:.�1 u+c only
\ Pcrmil Numbc-r
Lot
Signauu-c of LiaTSC^lPc e
SECTION 8-CONSTRUCTION SERVICES J
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
License Number
Address Expiration Date
Signature Telephone
. ntwcl
9 Reatsfer f- rnelii�grc�vementora+ctar r Not Applicable ❑
Company N me Registration Num er
Address Expiration Date
Telephone
SECTION 10 WORKERS'COMPENSATION-INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... ❑ No...... ❑
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
• as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm
structures.A person who constructs more than one home in a two-vear period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Anmotated,you mr,,be hzble f r norcnn/cl
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
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SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑, Replacement Windows Alteration(s) Roofing
Or Doors O
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [[] Siding[p] Other[❑]
Brief Description of Proposed`-
Work:
Alteration of existing bedroom Yes Y No Adding new bedroom Yes V;"No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
V,7 :.ox L„„
a: �w '"o se 1 i ex�sf rt+c sind.,' orrr a �Rtt a oflQUUr rr:
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
L Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I, Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER-AUTHORIZATION,-'TO BE_COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES'FOR BUICDfNGNPERMtt
I, as Owner of the subject
property
hereby authorize
to ar_,t on my behalf.in all matters relative to work authorized by this building permit application.
Signature of Owner Date
as-i=r/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury. '
Prig �.�-r� 1 — o
Signature of Owner/Agent Date
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Section 4. ZONING Al I Informatibh Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Rear
Building Height
Bldg.Square Footage
Open Space Footage %
(Lot area minus bldg&paved
#of Parking Spaces
(volume,&Location)
A. Ha's | Permit/Vahmnna/Finding ever been �suedfor/on thes�e?
NO dr DONT KNOW 0 YES 0
�
IF YES, date issuo&
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT0N0W 0 YES
IF YES: enter Book Page, and/or Document#
B. Does the site contain a brook, body of water orwetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has permit been or need to be obtained from the Conservation Commission?
~
Needs tobaobtained Obtaimed �-� 0mte [ssoed'
'
C. Do any signs exist on the property? YES 0 NO K�3
|F YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading, .nr filling)over 1 acre urish part ofo common plan
that will disturb over 1acre? YES � NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
R
r �- � � Department<useorJly .
City of Nortf ampton
Building Department
212 Main Street e t�
Room 100e v
Northampton; MA 01060 s
phone 413-587-1240 Fax 413-587-1272 `u '.s d.
c'sM'• y� �`�ie �` �7 3 `i^a r5 ek F
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITEINFORMAT(ON
1.1 Property Address: a�,� , �^ Th�ssechon�obecor�apietedb�n�ffice
K s _
C�,�
�_Y,,� `(��— 'Z'onex Overlay Distract
a Elm°St District z r `, EL stcZ
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mai in Address:
Telephone
Signature
2.2 Authorized Agent:
Na rint) T Current Mailing Address:
Sign Telephone
SECTION 3-"EST IMATED'CONSTRUCTION COSTS-
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building ,{a)'Building Permit Fee
2. Electrical ,(b)Estimated Total Cost of
Construction from 6
3. Plumbing Building,Permit Fee
4. mecnanicai(i-ivHG)
5. Fire Protection
6. Total=(1 +2+3+4+5) tjb Check Number
This Section For Official Use Only
Building Permit Number .,',Issued:
Signature:
c
Building Commissioner/inspectorof Buildings- Date
O C RW MAIN ST w BP-2006-0921
GIs#; COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-0921
Project# JS-2006-1405
Est. Cost: $0.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: CDT CONSTRUCTION 148610
Lot Size(sa.ft.): 15681.60 Owner: JEFFWAY LOUISE E
Zoning.URB Applicant: CDT CONSTRUCTION
AT. 85 NORTH MAIN ST
Applicant Address: Phone: Insurance:
158 NORTH MAPLE ST (413) 585-8677
FLORENCEMA01062 ISSUED ON:311612006 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType• Date Paid: Amount:
Building 3/16/2006 0:00:00 $25.006991
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo